Modified double-eyelid blepharoplasty with the combined partial- And minimal-incision method.

BACKGROUND: Double-eyelid surgery remains a popular esthetic surgery in East Asian people. The partial-incision method provides the benefits of full-incision and nonincision techniques. It can create a predictable and durable double-eyelid crease. AIMS: To create a long-lasting double-eyelid crease with a minimal scar, the author has described the modified partial incision technique with a small and minimal incision. PATIENTS/METHODS: A preoperative design was developed with the patient in an upright sitting position. A partial incision was made between the medial limbus and the middle pupillary line; the minimal incision was made just adjacent to the lateral limbus. After local anesthesia, a strip of orbicularis oculi below the incision was dissected, and the pretarsal orbicularis oculi, anterior tarsal fascia and part of the anterior tarsal fat were removed. The skin, dermis and orbicularis oculi were sutured together with the pretarsal fascia. RESULTS: From July 2016 to September 2018, 138 patients received a modified partial-incision double-eyelid surgery. A total of 119 patients were followed up. The postoperative shape and height were stable. Five patients developed loss of the unilateral fold (2.17%), and one patient complained of bilateral narrow eyelid folds (0.87%). No serious complications were noted. CONCLUSION: The modified partial-incision technique for creating a double eyelid described here provides stable results with no visible scar and no serious complications.

Partial Incision Double Fold Operation Using Debulking Method

Double fold operation is one of the most common cosmetic operations performed on young adults in Korean. These days, as many women are working outside home, growing number of women who want to have a natural-looking double eyelid choose the method with not only a short recovery time and less discomfort but also definite long lasting double fold. Double fold operation can be classified as incision technique and non incision technique. Although there are various non-incision techniques yielding good result, these techniques still have some problems, such as loosening of double fold with time, cyst formation, conjunctivitis and so on. Incision techniques also have problems such as long recovery time, irreversibility and visible scar. Our technique uses two or three 4-5mm of partial incision and removes the subcutaneous fat, pretarsal muscle, and small part of orbital septum through small incisions. And then we suture the wound skin to skin through levator aponeurosis and upper part of tarsal plate. These procedures prevent the possible problem of loosening of the folds of non-incision method by creating scar- adhesion between wider portion of the dermis and the tarsal plate and allows the application on puffy eyelid without any difficulty and is expectable of short recovery time. A retrospective review of data for 154 patients who underwent the partial-incision blepharoplasty using debulking method from November 2000 through april 2003 is presented. Most results were successful except 3 cases. Two patients complained of weak fold and one patient complained of short fold line. Satisfactory results in most patients prompt us to report this method, and we hope this debulking method complement the existing incision and non-incision method.

Double Eyelid Operation Using Partial Incision and Continuous Buried Suture

e double eyelid operation is one of the most common aesthetic operation in Korea. The non-incision method have advantage such as decreased swelling, faster recovery and so forth. However difficulties arise in case of excessively fatty upper eyelids. The authors have devised a method for use with the fatty upper eyelid. Through the partial incision, orbital fat was removed and the double fold was made with the continuous buried suture technique. This technique was performed in 215 cases in 462 total double eyelid operation in Metro Plastic Surgery Clinic from August 2000 to May 2002. We experienced satisfactory results in all cases except 1 case of asymmetry and 1 case of fold loss. The authors conclude that this method achieves a shorter operation time, less morbidity and better cosmetic results in fatty upper eyelids than the other incision methods.

Cosmetic Double Eyelid Surgery: Single 5 mm-Partial Incision Method

In Asian double eyelid surgery, there have been two approaches to form a suprapalpebral fold: the buried suture (nonincision) method and the full external incision method. Usually excessive fat tissue in upper eyelid has been removed by using a full external incision method, or 2 to 3 partial incisions with buried suture method. The full external incision method is more invasive than the buried suture method, which is not suitable for patients with excessive orbital fat. From March 1999 to January 2002, we have introduced the single 5 mm-partial incision method to 216 patients. This method is applied to patients who have excessive amount of orbital fat or those who do not have excessive orbital fat but which must be removed for better result. These patients have bulging supra-crease areas when we form suprapalpebral folds with a curved wire loop preoperatively. Excessive orbital fat was removed through a single 5 mm incision in the middle of designed eyelid crease and tarso-dermal suture was performed. At another 2 to 3 points, through skin stab punctures by using 18 gauge needle, full-thickness eyelid tarso-dermal sutures were done. Pretarsal and preseptal orbicularis muscles were preserved. If muscles were removed, that could result in thinning of the overlying skin and could make suprapalpebral fold unnatural. This method has several advantages. First, we could perform the operations safely in patients who have excessive fat tissue, without a full external incision. Second,fat tissue can be removed almost totally by a single 5 mm-partial incision. Third, we can minimize the scar formation, and the possibility of complications, and make healing process and operation time shorter compared to the full incision technique. However a very delicate technique is required in this method. In patients who have a thick orbital septum, a superiorly located fat pad, and a bleeding tendency, exposure of fat tissue could be difficult and injury of levator muscle aponeurosis is possible. The complications of this method are the possibility of disappearing of the crease with the lapse of time(3 percents), and suture granuloma formation(less than 1 percent). In conclusion, patients who have excessive fat tissue in upper eyelid don't have to proceed a full incision, and can have more excellent results with this single 5 mm-partial incision method.